Provider Demographics
NPI:1154972974
Name:EUGENE A BONAROTI MD FAC LLC
Entity type:Organization
Organization Name:EUGENE A BONAROTI MD FAC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BONAROTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-275-0227
Mailing Address - Street 1:100 PENNSYLVANIA AVE LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 PENNSYLVANIA AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3552
Practice Address - Country:US
Practice Address - Phone:412-275-0227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty